Postpartum Maternal Complications

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Question 1
Free
Multiple Choice

Which statement by a postpartum client indicates that further teaching is not needed regarding thrombus formation?

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A

"I'll keep my legs elevated with pillows."

B

"I'll sit in my rocking chair most of the time."

C

"I'll stay in bed for the first 3 days after my baby is born."

D

"I'll put my support stockings on every morning before rising."

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Question 2
Free
Multiple Choice

The nurse knows that late postpartum hemorrhage can be prevented by:

Choose correct answer/s
A

manually removing the placenta.

B

inspecting the placenta after birth.

C

administering broad-spectrum antibiotics.

D

pulling on the umbilical cord to hasten the birth of the placenta.

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Question 3
Free
Multiple Choice

A multiparous client is admitted to the postpartum unit after a rapid labor and birth of a 4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the client void and massages her fundus, but the fundus remains difficult to find and the rubra lochia remains heavy. Which action should the nurse take next?

Choose correct answer/s
A

Recheck vital signs.

B

Insert a Foley catheter.

C

Notify the health care provider.

D

Continue to massage the fundus.

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Question 4
Free
Multiple Choice

Early postpartum hemorrhage is defined as a blood loss greater than:

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A

500 mL within 24 hours after a vaginal birth.

B

750 mL within 24 hours after a vaginal birth.

C

1000 mL within 48 hours after a cesarean birth.

D

1500 mL within 48 hours after a cesarean birth.

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Question 5
Free
Multiple Choice

A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests:

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A

uterine atony.

B

perineal hematoma.

C

infection of the uterus.

D

lacerations of the genital tract.

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Question 6
Multiple Choice

A postpartum client would be at increased risk for postpartum hemorrhage if she delivered a(n):

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A
5-lb, 2-oz infant with outlet forceps.
B
6.5-lb infant after a 2-hour labor.
C
7-lb infant after an 8-hour labor.
D
8-lb infant after a 12-hour labor.
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Question 7
Multiple Choice

Which instruction should be included in the discharge teaching plan to assist the client in recognizing early signs of complications?

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A
Palpate the fundus daily to ensure that it is soft.
B
Report any decrease in the amount of brownish red lochia.
C
The passage of clots as large as an orange can be expected.
D
Notify the health care provider of any increase in the amount of lochia or a return to bright red bleeding.
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Question 8
Multiple Choice

The nurse should expect medical intervention for subinvolution to include:

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A
oral fluids to 3000 mL/day.
B
intravenous fluid and blood replacement.
C
oxytocin intravenous infusion for 8 hours.
D
oral methylergonovine maleate (Methergine) for 48 hours.
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Question 9
Multiple Choice

If nonsurgical treatment for subinvolution is ineffective, which surgical procedure is appropriate to correct the cause of this condition?

Choose correct answer/s
A
Hysterectomy
B
Laparoscopy
C
Laparotomy
D
Dilation and curettage (D&C)
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Question 10
Multiple Choice

A sign of thrombophlebitis is:

Choose correct answer/s
A
visible varicose veins.
B
positive Homans sign.
C
pedal edema in the affected leg.
D
local tenderness, heat, and swelling.
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Question 11
Multiple Choice

Which nursing measure would be appropriate to prevent thrombophlebitis in the recovery period following a cesarean birth?

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A
Limit the client's oral intake of fluids for the first 24 hours.
B
Assist the client in performing leg exercises every 2 hours.
C
Ambulate the client as soon as her vital signs are stable.
D
Roll a bath blanket and place it firmly behind the client's knees.
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Question 12
Multiple Choice

Which temperature indicates the presence of postpartum infection?

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A
99.6° F in the first 48 hours
B
100° F for 2 days postpartum
C
100.4° F in the first 24 hours
D
100.8° F on the second and third postpartum days
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Question 13
Multiple Choice

A white blood cell (WBC) count of 35,000 cells/mm³ on the morning of the first postpartum day indicates:

Choose correct answer/s
A
possible infection.
B
normal WBC limit.
C
serious infection.
D
suspicion of a sexually transmitted disease.
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Question 14
Multiple Choice

The client who is being treated for endometritis is placed in the Fowler position because it:

Choose correct answer/s
A
promotes comfort and rest.
B
facilitates drainage of lochia.
C
prevents spread of infection to the urinary tract.
D
decreases tension on the reproductive organs.
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Question 15
Multiple Choice

Nursing measures that help prevent postpartum urinary tract infection include:

Choose correct answer/s
A
forcing fluids to at least 3000 mL/day.
B
promoting bed rest for 12 hours after birth.
C
encouraging the intake of orange, grapefruit, or apple juice.
D
discouraging voiding until the sensation of a full bladder is present.
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Question 16
Multiple Choice

Which measure may prevent mastitis in a breastfeeding client?

Choose correct answer/s
A
Wearing a tight-fitting bra
B
Applying ice packs prior to feeding
C
Initiating early and frequent feedings
D
Nursing the infant for 5 minutes on each breast
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Question 17
Multiple Choice

A client with mastitis is concerned about breastfeeding while she has an active infection. Which is an appropriate response by the nurse?

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A
Organisms will be inactivated by gastric acid.
B
Organisms that cause mastitis are not passed to the milk.
C
The infant is not susceptible to the organisms that cause mastitis.
D
The infant is protected from infection by immunoglobulins in the breast milk.
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Question 18
Multiple Choice

The nurse expecting a uterine infection in a postpartum client should assess the:

Choose correct answer/s
A
episiotomy site.
B
odor of the lochia.
C
abdomen for distention.
D
pulse and blood pressure.
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Question 19
Multiple Choice

Following a difficult vaginal birth of a singleton pregnancy, the client starts bleeding heavily. Clots are expressed and a Foley catheter is inserted to empty the bladder because the uterine fundus is soft and displaced laterally from midline. Vital signs are 99.8° F, pulse 90 beats/min, respirations 20 breaths/min, and BP 130/90 mm Hg. Which pharmacologic intervention is indicated?

Choose correct answer/s
A
Oxytocin (Pitocin) to be administered in a piggyback solution
B
Administration of methylergonovine (Methergine)
C
Administration of prostaglandin analogue
D
Increase in parenteral fluids
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Question 20
Multiple Choice

Following a vaginal birth, a client has lost a significant amount of blood and is starting to experience signs of hypovolemic shock. Which clinical signs would be consistent with this clinical diagnosis?

Choose correct answer/s
A
Decrease in blood pressure, with an increase in pulse pressure
B
Compensatory response of tachycardia and decreased pulse pressure
C
Decrease in heart rate and an increase in respiratory effort
D
Flushed skin
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